Information Collection

57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)

IC 183558 under ICR 201407-0920-007 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CDC 57.118 57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)	Form
CDC 57.118 Denominators for Intensive Care Unit (ICU)/Other Locatio 57.118_DenominatorICU_BLANK.docx	Form
Att G.6_Inst for Completion of Denominators (NICU).pdf Att G.6_Inst for Completeion of Denominatiors (NICU)	IC Document

IC Title:

57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CDC 57.118	Denominators for Intensive Care Unit (ICU)/Other Locations (not NICU or SCA)	57.118_DenominatorICU_BLANK.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	324,000	324,000
Annual IC Time Burden (Hours)	1,620,000	1,620,000
Annual IC Cost Burden (Dollars)	50,997,600	50,997,600

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att G.6_Inst for Completeion of Denominatiors (NICU)	Att G.6_Inst for Completion of Denominators (NICU).pdf	08/25/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.